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Treatment and response of superior vena cava syndrome due to malignant tumours
S162
Proffered
894
Pawrs 895
ACTUAL INDICATIONS TO ENDOSCOPIC LASER-THERAPY IN THE LUNG CANCER NON-SMALL CELL. lriezzetti M Department of Thoracic Surgery,University of WI& lan,Nilan,Italy. ,riore than half of the lung cancers,non-small cell,ce.n't be resected and the research of the best palliative treatment is actual.When the tumor is not resectable,is central and involving a main or a lobar bronchus and has an important intraluminal component,the andoscopic laser-the rapy,looking at evaporation of the tumor and at reopening of the bronchus,has today a correct indication.From darch 1987 to January 1993 306 patients have been treated,1089 applications in all.We have observed no complication related to laser,a reopening of bronchi,with a significant radiological modification in 75% of cases and on an average the period for bronchial reopening.i:sof 4 months.1 think that ,in specified cases,as before remembered,laser therapy give good results. 897 TREATMENT AND RESPONSE OF SUPERIOR VENA CAVA SYNDROMEDUE TO MRLIGNANT TUMOURE. Evangelia M. Kondili, E.Michallakis, N.Pergantas, N.P.Moschopoulos,N.A. Riil6ii?+;KF.Samelis, P.Papacostas, G.P.Stathopoulos. Hippokration Hospital Oncology Dept. 2nd Division of Medicine, Athens, University. Superior vena cava syndrome is coaawnly due to malignant tumors often incurahla . In the present study we reviewed the response rate and survival of such svndrome after treatment with radiotheraov and/or chemotherapy. Material 18 patients were included and evalu&d. ble 16 female 2. Performance status >60%. Median age 57(37-811. Histologically were 3 small cell lllno cancers. 8 non-small cell luno cancer.1 thvmoma. 12 pati&s were'initially treated witg radiotherapi (Rt) Treatment (5; NSCLC, one thymoma)and 6with chemotherapy (4 SCLC and 2 NSCLC). Chemotherapy was Cis-platinum based combination. Response. Of 12 patients with Rt, 8 responded (66%), 3 of 5 SCLC, 5 of 6 NSCLC. 6 of 6 patients with chemotherapy responded (lOO%).Ona patient with thymoma did-not responde to Rt and responded to chemotherapy. Response was considered objective reduction of measurable turnour and also Median survival was 9 months reduction of superior vena cava signs. (3-20+). Chmotherapy may be equally effective as initial treatment Conclusion: of superior vena cava syndrome due to small cell lung cancer, non-.small cell lung cancer and thymoma as radiotherapy,if not superior.
TREATMENT OF NON-SMALL CELL LUNG CANCER (NSCLC)
STAGE IIIb-IV
WITH
IFOSFAMIDE (IF),
~EPI~OXORUBICIN (EPI) AND MITOMVCIN c (MMC). PRELIMINxx x 1 *Pirisi ARY REPORT. 'Brocato N, Bruno M, Araujo C.E. Orlandi L, C, 'Sparrow C, 'Temperley G, 'Savulsky C. x *Hosp.B.Houssay (Bs.Aires), 'Hosp.Bancario (Bs.Aires), Gas de1 Estado (Bs.Aires),
"Clinica
Mella
(Santiago
de Chile).
From March 1991 to February 1993. 72 patients (pts) with Stage IIIb-IV NSCLC and non prior treatment were randomized to receive combination chemotherapy as follows: Arm A: IF 2500 mglm2 IV, day 1 and 2; Mema 20% of
IF dose
IV at
huuur 0, 3. 6 and 9; EPI 70 mg/m2 IV day 1 and as in arm A, but 1. Arm 8: the same schedule were repeated every four weeks. 34 pts were
MMC 6 mg/m2 IV, day without MMC. Cycles
evaluated in arm A and 33 pts in arm B. In arm A, 14 ptS achieved (41%) objective response (CR 4, PR 10); arm B: 14 pts achieved (42.4%) disease was seen in objecti,w response (CR 0, PR 14). Progressive 11 pts (arm A), 9.5 months (mo) time
for
and in 8 pts (arm B). Median time remission is about for arm A. and about 8+ mu for arm B. Median SurViVal
responders
is
11 mo for
arm A and IO mo for
ranged from mild to moderate (OMS II-III). a useful combination for NSCLC. The inclusion response
arm B. Toxicity
IF + EPI seems to be of MMC did not improve
and survival.
898
899
PHASE II TRIAL WITH WEEKLY CISPLATIN (CDDP) AND CONTINOUSLY ORAL ETOPOSIDE (VP-161 IN ADVANCED NONSMALL CELL LUNG CANCER (NSCLC). R. Looez, Ft. Fernandez, J.A. Virizuela, J. Cueva, E. Garcia, A. Sanz, J.J. Valerdi, J.M. Gracia. Hospital de Navarra; Hospital de Cabuenes; Hospital General de Huelva, Hospital Central de Asturias; Spain. We performed a phase II trial with VP-l 6 50 mg/m2/day po day 1-21 q28 and CDDP 35 mg/m2 iv day 1,8 and 15 q28. Forty three untreated patients (ptsI(38 male/5 female) with histologically proven and inoperable NSCLC were included. All pts had evaluable disease by CT scan. Median age was 57 years (range: 33-70). Stage IIIA 4 pts, stage IIIB 18 pts and stage IV 21 pts. Histology was squamous 22 pts, adenocarcinoma 17 pts and large cell/poorly differentiated 4 pts. Performance status WHO O-l, 32 pts and WHO 2, 11 pts. 3 pts were not evaluable for response (2 death of intercurrent disease, 1 lost follow-up). A median of 3 cycles was given (range l-8). The response rate was 50% (20/40) (95% Cl: 35%-65%) with 3 pts achieving complete response (7.5%). On stage IV overall response rate was 45% (g/20)(95% Cl: 24%-66%). Severe toxicity (WHO 3-4) included leukopenia 16% of all pts, anemia 9%, diarrhea lo%, mucositis 14%. Nausea/vomiting grade 1-2 in 40%. Alopecia grade 2-3 was common (90%). We conclude that this ambulatory regimen was well tolerated and achieved a promising response rate. A phase Ill study is warranted.
PHASE II STUDY OF TOPGTECAN lN PATIBNTS WITH NONSMALL CELL LUNG CANCER.J+ez-SW, Glisson BS, Rane J, Raber MN, Hong WK. M.D.Anderson Cancer Center, Houston, TX. Topotecau is a hydmsoluble semisynthetic analogue of camptothecin undergoing extensive clinical evaluation. A Phase II clinical trial of Topotecan in patients with metastatic non-small cell lung cancer previously untreated is in progress. Topotecan is administered i.v. as a 30 min daily infusion for 5 consecutive days at a dose of 1.5 mg/mVday. Twenty one patients have been entered into the study. Fin patients are evaluable for response and toxicity. Characteristics of evaluable patients are as follows: h&&gy: sdenccaminoma 7, squamous cell carcinoma 3, poorly differentiated carcinoma 4, bronchioalveolar carcinoma 1; Dcrformancc: 0.3 patients, 1,12 patients. Two patients (13.3%) have achieved a partial remission (50% reduction in measurable disease for 24 weeks), 3 patients (20%) a minor reponse, 3 patients have remained stable, and 7 patients have shown progressive disease. From a total of 52 courses given, grade 3 or 4 toxicity has been limited to myelosuppression (predominantly granulocytopenia) lasting <7 days in most patients; two epidoses of neutropenic fever mqriring hospitalization have been recorded other toxicities include alopecia in most patients and grade 1 or 2 nausea and vomiting in about 50% of patients. Although preliminary, these results indicate that Topotecan has moderate activity in non-small cell lung cancer and is easily tolerated. Accrual will continue up to 40 evaluable patients.
Proffered
894
Pawrs 895
ACTUAL INDICATIONS TO ENDOSCOPIC LASER-THERAPY IN THE LUNG CANCER NON-SMALL CELL. lriezzetti M Department of Thoracic Surgery,University of WI& lan,Nilan,Italy. ,riore than half of the lung cancers,non-small cell,ce.n't be resected and the research of the best palliative treatment is actual.When the tumor is not resectable,is central and involving a main or a lobar bronchus and has an important intraluminal component,the andoscopic laser-the rapy,looking at evaporation of the tumor and at reopening of the bronchus,has today a correct indication.From darch 1987 to January 1993 306 patients have been treated,1089 applications in all.We have observed no complication related to laser,a reopening of bronchi,with a significant radiological modification in 75% of cases and on an average the period for bronchial reopening.i:sof 4 months.1 think that ,in specified cases,as before remembered,laser therapy give good results. 897 TREATMENT AND RESPONSE OF SUPERIOR VENA CAVA SYNDROMEDUE TO MRLIGNANT TUMOURE. Evangelia M. Kondili, E.Michallakis, N.Pergantas, N.P.Moschopoulos,N.A. Riil6ii?+;KF.Samelis, P.Papacostas, G.P.Stathopoulos. Hippokration Hospital Oncology Dept. 2nd Division of Medicine, Athens, University. Superior vena cava syndrome is coaawnly due to malignant tumors often incurahla . In the present study we reviewed the response rate and survival of such svndrome after treatment with radiotheraov and/or chemotherapy. Material 18 patients were included and evalu&d. ble 16 female 2. Performance status >60%. Median age 57(37-811. Histologically were 3 small cell lllno cancers. 8 non-small cell luno cancer.1 thvmoma. 12 pati&s were'initially treated witg radiotherapi (Rt) Treatment (5; NSCLC, one thymoma)and 6with chemotherapy (4 SCLC and 2 NSCLC). Chemotherapy was Cis-platinum based combination. Response. Of 12 patients with Rt, 8 responded (66%), 3 of 5 SCLC, 5 of 6 NSCLC. 6 of 6 patients with chemotherapy responded (lOO%).Ona patient with thymoma did-not responde to Rt and responded to chemotherapy. Response was considered objective reduction of measurable turnour and also Median survival was 9 months reduction of superior vena cava signs. (3-20+). Chmotherapy may be equally effective as initial treatment Conclusion: of superior vena cava syndrome due to small cell lung cancer, non-.small cell lung cancer and thymoma as radiotherapy,if not superior.
TREATMENT OF NON-SMALL CELL LUNG CANCER (NSCLC)
STAGE IIIb-IV
WITH
IFOSFAMIDE (IF),
~EPI~OXORUBICIN (EPI) AND MITOMVCIN c (MMC). PRELIMINxx x 1 *Pirisi ARY REPORT. 'Brocato N, Bruno M, Araujo C.E. Orlandi L, C, 'Sparrow C, 'Temperley G, 'Savulsky C. x *Hosp.B.Houssay (Bs.Aires), 'Hosp.Bancario (Bs.Aires), Gas de1 Estado (Bs.Aires),
"Clinica
Mella
(Santiago
de Chile).
From March 1991 to February 1993. 72 patients (pts) with Stage IIIb-IV NSCLC and non prior treatment were randomized to receive combination chemotherapy as follows: Arm A: IF 2500 mglm2 IV, day 1 and 2; Mema 20% of
IF dose
IV at
huuur 0, 3. 6 and 9; EPI 70 mg/m2 IV day 1 and as in arm A, but 1. Arm 8: the same schedule were repeated every four weeks. 34 pts were
MMC 6 mg/m2 IV, day without MMC. Cycles
evaluated in arm A and 33 pts in arm B. In arm A, 14 ptS achieved (41%) objective response (CR 4, PR 10); arm B: 14 pts achieved (42.4%) disease was seen in objecti,w response (CR 0, PR 14). Progressive 11 pts (arm A), 9.5 months (mo) time
for
and in 8 pts (arm B). Median time remission is about for arm A. and about 8+ mu for arm B. Median SurViVal
responders
is
11 mo for
arm A and IO mo for
ranged from mild to moderate (OMS II-III). a useful combination for NSCLC. The inclusion response
arm B. Toxicity
IF + EPI seems to be of MMC did not improve
and survival.
898
899
PHASE II TRIAL WITH WEEKLY CISPLATIN (CDDP) AND CONTINOUSLY ORAL ETOPOSIDE (VP-161 IN ADVANCED NONSMALL CELL LUNG CANCER (NSCLC). R. Looez, Ft. Fernandez, J.A. Virizuela, J. Cueva, E. Garcia, A. Sanz, J.J. Valerdi, J.M. Gracia. Hospital de Navarra; Hospital de Cabuenes; Hospital General de Huelva, Hospital Central de Asturias; Spain. We performed a phase II trial with VP-l 6 50 mg/m2/day po day 1-21 q28 and CDDP 35 mg/m2 iv day 1,8 and 15 q28. Forty three untreated patients (ptsI(38 male/5 female) with histologically proven and inoperable NSCLC were included. All pts had evaluable disease by CT scan. Median age was 57 years (range: 33-70). Stage IIIA 4 pts, stage IIIB 18 pts and stage IV 21 pts. Histology was squamous 22 pts, adenocarcinoma 17 pts and large cell/poorly differentiated 4 pts. Performance status WHO O-l, 32 pts and WHO 2, 11 pts. 3 pts were not evaluable for response (2 death of intercurrent disease, 1 lost follow-up). A median of 3 cycles was given (range l-8). The response rate was 50% (20/40) (95% Cl: 35%-65%) with 3 pts achieving complete response (7.5%). On stage IV overall response rate was 45% (g/20)(95% Cl: 24%-66%). Severe toxicity (WHO 3-4) included leukopenia 16% of all pts, anemia 9%, diarrhea lo%, mucositis 14%. Nausea/vomiting grade 1-2 in 40%. Alopecia grade 2-3 was common (90%). We conclude that this ambulatory regimen was well tolerated and achieved a promising response rate. A phase Ill study is warranted.
PHASE II STUDY OF TOPGTECAN lN PATIBNTS WITH NONSMALL CELL LUNG CANCER.J+ez-SW, Glisson BS, Rane J, Raber MN, Hong WK. M.D.Anderson Cancer Center, Houston, TX. Topotecau is a hydmsoluble semisynthetic analogue of camptothecin undergoing extensive clinical evaluation. A Phase II clinical trial of Topotecan in patients with metastatic non-small cell lung cancer previously untreated is in progress. Topotecan is administered i.v. as a 30 min daily infusion for 5 consecutive days at a dose of 1.5 mg/mVday. Twenty one patients have been entered into the study. Fin patients are evaluable for response and toxicity. Characteristics of evaluable patients are as follows: h&&gy: sdenccaminoma 7, squamous cell carcinoma 3, poorly differentiated carcinoma 4, bronchioalveolar carcinoma 1; Dcrformancc: 0.3 patients, 1,12 patients. Two patients (13.3%) have achieved a partial remission (50% reduction in measurable disease for 24 weeks), 3 patients (20%) a minor reponse, 3 patients have remained stable, and 7 patients have shown progressive disease. From a total of 52 courses given, grade 3 or 4 toxicity has been limited to myelosuppression (predominantly granulocytopenia) lasting <7 days in most patients; two epidoses of neutropenic fever mqriring hospitalization have been recorded other toxicities include alopecia in most patients and grade 1 or 2 nausea and vomiting in about 50% of patients. Although preliminary, these results indicate that Topotecan has moderate activity in non-small cell lung cancer and is easily tolerated. Accrual will continue up to 40 evaluable patients.